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122 CHAPTER 5 ■ Tuberculosis: Keys to Success in Peru

Association of Tuberculosis Patients was an important partner in advocacy,
and national pharmaceutical industry and private medical practitioners facil-
itated pooled purchasing of TB drugs at the national level (Llanos-Zavalaga
et al., 2004).
Nongovernmental organizations also played an active role, with local
churches and community-based organizations providing outreach to the com-
munity and a link to health clinics. As mentioned earlier, in 1995 NTCP estab-
lished community organizations called Community Surveillance Units (CSUs)
to help detect TB and follow up on treatment. The CSUs played an important
role in linking the health team to the community. By 2000, 22,672 CSUs with
48,420 volunteers were serving 751,771 families. Other important community
groups included mother groups, patient and family support groups, and Family
Parents Associations. These groups allowed the community to feel ownerships
of the program and played an important role in case detection and ensuring
treatment compliance (Llanos-Zavalaga et al., 2004).

OUTC OM ES

In 2000, WHO reported promising results in Peru, touting its TB program as
“one of the world’s most successful DOTS programs in the world . . . one of only
a handful of high-burden countries to have met the WHO targets for TB control
of 70% case detection rates and 85% cure rates.” By 1998, in fact, an estimated
94% of TB cases were being detected and 90% of patients were being cured, pre-
venting close to 70,000 cases and deaths.
The number of health centers participating in the program soared from
1,000 in 1991 to more than 6,000 by 1999. And as efforts to detect new cases in-
tensified, the number of laboratories capable of carrying out smear tests rose
from 300 in 1989 to more than 1,000 by 1999 (WHO, 2008c).

P O STN OTE

While Peru succeeded in the late 1990s in meeting the targets set by WHO, the
country now faces new challenges: MDR-TB and co-infection with HIV/AIDS.
Many believe that new commitments have been made to address this, and efforts
have been redoubled. For example, a grant from The Global Fund will help fi-
nance the treatment of MDR-TB for 2,000 patients and their families. The grant
will also aid Peru in its goal to increase its tuberculosis detection rate to 100%.
The program will focus on the high-risk populations, including prisoners and